Tranquil Minds Counseling Privacy Policy

EFFECTIVE DATE OF THIS NOTICE

This notice went into effect on May 15, 2025.

NOTICE OF PRIVACY PRACTICES

This notice describes how health information may be used and disclosed and how you can get access to this information. Please review it carefully.

I. PURPOSE AND SCOPE REGARDING YOUR HEALTH INFORMATION:

I understand that all information describing your mental health treatment and related health care services is personal, and I am committed to protecting the privacy of any health information you disclose. I am required by law to maintain the confidentiality of information that identifies you and the care you receive. Information about you and your care that may identify you and that relates to your past, present, or future physical or mental health and related health care services is referred to as Protected Health Information (“PHI”). I am required to give you notice of my legal duties and privacy practices with respect to your health information. This notice applies to all of the records of your care generated by this mental health care practice. This notice describes my policies related to how I may use and disclose your PHI in accordance with applicable law, including the Health Insurance Portability and Accountability Act (“HIPAA”).

II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:

Generally, I may not “use” or “disclose” your PHI without your permission, and must use or disclose your PHI in accordance with the terms of your permission. “Use” basically refers to activities within the office. “Disclosure” basically refers to activities involving parties outside of the office. The following are the circumstances under which I am permitted or required to use or disclose your PHI. In all cases, I am required to limit such uses or disclosures to the minimal amount of PHI that is reasonably required (Minimum Necessary Rule).

Treatment, Payment, and Health Care Operations:

Without your written authorization, I may use within the office, or disclose to those outside the office, your PHI in order to provide you with the treatment you require or request, to collect payment for services, and to conduct other related health care operations.

• Treatment activities include: use of PHI within the office by professional staff/provider for the service, management, and coordination of your health care; contacting you to provide appointment reminders, information about treatment alternatives/referrals, or other health related services that may be of interest to you; and disclosure of PHI to another licensed health care provider for the purpose of continuity of care, consultation, or referral.
• Payment activities include: disclosure of PHI with your insurance plan adminstrators to determine coverage, comply with their requested reviews, and adjudication of health benefit claims; disclosures for billing practices in which I utilize the services of outside billing companies and claims processing companies with which I have Business Associate Agreements that protect the privacy of your PHI; and disclosures to attorneys, courts, collection agencies and consumer reporting agencies, of information as necessary for the collection of unpaid fees, provided that I notify you in writing prior to making collection efforts that require disclosure of your PHI.
• Health care operations activities include: use of PHI within the office for staff training, internal quality control, auditing functions, and general administrative activities; and disclosures to consultants of my health care operations provided that I have entered into Business Associate Agreements with such consultants for the protection of your PHI.

Special Situations

In special circumstances, I may use or disclose your PHI without your written authorizationand in accordance with HIPAA or as required by law.

Some examples include:

• As required or authorized by mandatory reporting laws - such as, the reporting of child abuse or neglect, including reporting to child protective services or social services.
• For State Legislative Committees - such as, for legislative investigations.
• For health oversight activities - such as, audits, civil, administrative, or criminal investigations, inspections, licensure or disciplinary actions, civil, administrative, or criminal proceedings or actions, or other activities necessary for appropriate oversight of government benefit programs.
• For judicial proceedings - such as, in response to court/administrative orders, subpoenas, discovery requests or other legal processes.
• For public health authorities - such as, to prevent or control communicable disease, injury or disability, or ensure the safety of drugs and medical devices.
• For law enforcement - such as, to assist in an involuntary hospitalization process.
• For research purposes - such as, where your PHI has been de-identified, so that it no longer identifies you by name and cannot be associated with you.
• For threats to health or safety - such as, to protect you or others from a serious imminent risk of danger.
• For worker’s compensation claims
• For family members, friends, and others involved in your care or the payment of your care - only if you are present and give oral permission, unless mandatory reporting laws are in effect (the opportunity to consent may be obtained retroactively in emergency situations).

III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:

Except as otherwise permitted or required as described above, I may not use or disclose your PHI without your written authorization. Written authorization is required, among other uses and disclosures, for:

• Most uses and disclosures of “psychotherapy notes” - unless the use or disclosure is for my treatment of you, for training or supervision purposes, to defend myself in legal proceedings, for investigations by HHS regarding HIPAA compliance, or as required by law, by a coroner, or to help avert a serious threat of harm. “Psychotherapy Notes” are defined as confidential records taken during individual, group, or family counseling sessions which may be maintained in addition to and separate from medical or healthcare records.
• Marketing purposes - I do not plan to use or disclose your PHI for marketing purposes.
• Sale of PHI - I will not to sell your PHI without authorization and do not plan to do so as a course of my business.

IV. YOUR RIGHTS WITH RESPECT TO YOUR PHI:

Under HIPAA, you have certain rights with respect to your PHI. The following is an overview of your rights and my duties with respect to enforcing those rights.

• The Right to Request Restrictions on Uses and Disclosures of Your PHI - You have the right to ask me not to use or disclose certain PHI for treatment, payment, or health care operations purposes. Although I am not required to agree, if I do agree to a restriction, I am bound not to use or disclose your PHI in violation of such restriction, except in certain emergency situations. I will not accept a request to restrict uses or disclosures that are otherwise required by law. All requests for restrictions must be in writing and specify (1) the information to be restricted, (2) the type of restriction being requested, (3) to whom the limits apply, and (4) state a reason for the request.
• The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full - You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or service that you have paid for out-of-pocket and in full.
• The Right to Receive Confidential Communications by Alternate Means or Locations - You have the right to make reasonable requests that I contact you in by alternate means or to alternate locations. I will ask you about your preferences for communication. I must agree to your request if you inform me that certain means of communicating with you will place you in danger.
• The Right to View and Receive Copies of Your PHI, Even in Electronic Format - You have the right of access in order to inspect, and/or to obtain a copy of your PHI, including any PHI maintained in electronic format, except for: “psychotherapy notes”; information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding; health information maintained by me to the extent to which the provision of access to you is at my discretion, and I exercise my professional judgment to deny you access; and, health information maintained by me to the extent to which the provision of access to you would be prohibited by law.
  All requests for copies of your PHI must be in writing. You may request your PHI in the format of your choice, and where feasible, I will comply. If you request a copy of your PHI, you will be charged a fee for copying, or for electronic records, for labor and supplies, if allowed within the confines of Federal and state law. I reserve the right to deny you access to and copies of all or certain PHI as permitted or required by law. Upon denial of a request for access or request for information, I will provide you with a written denial specifying the basis for denial, a statement of your rights, and a description of how you may file an appeal or complaint.
• The Right to Amend or Update Your PHI - You have the right to request that I amend or update your PHI, and if approved, I will make reasonable efforts to provide the amendment within reasonable time. I have the right to deny your request for amendment, and if this the case, I will provide you with a written denial stating the basis of the denial, your right to submit a written statement disagreeing with the denial, and a description of how you may file a complaint.
• The Right to Receive an Accounting of Disclosures I Have Made - You have the right to request a list of instances in which I have disclosed your PHI within a 6 year (or less) time period immediately preceding the date on which the accounting is requested. All requests must be made in writing, and I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The accounting will include: the date of disclosure, the name and (if known) the address of the entity or person who received the information, a brief description of the information disclosed, and a brief statement of the purpose and basis of the disclosure or, instead of such statement, a copy of your written authorization or written request for disclosure pertaining to such information. I am not required to provide accountings of disclosures for the following purposes: (a) treatment, payment, and healthcare operations, (b) disclosures pursuant to your authorization, (c) disclosures to you, (d) to other healthcare providers involved in your care, (e) for national security or intelligence purposes, (f) to correctional institutions, or (f) disclosures made prior to 3/10/2025. I will provide the first accounting to you in any twelve (12) month period without charge, but will impose a reasonable cost-based fee for responding to each subsequent request for accounting within that same twelve (12) month period.
• Right To Notification If There Is A Breach of Your PHI - If there is a breach in my protecting of your PHI, I will follow HIPAA guidelines to evaluate the circumstances of the breach, document my investigation, retain copies of the evaluation, and where necessary, report breaches to HHS. Where a report is required to HHS, I will also give you notification of any breach.
• The Right to Get a Paper or Electronic Copy of this Notice - You have the right to get a paper copy of this notice, and you have the right to get an electronic copy of this notice.

V. AMENDMENTS TO THIS NOTICE OF PRIVACY PRACTICES

Terms of this notice may be revised or amended at any time. These revisions or amendments may be made effective for all PHI I maintain, even if created or received prior to the effective date of the revision or amendment. A copy of the amended privacy practices will be available upon written request and will be posted on my website (www.tranquilminds-counseling.com).

Contact Information

If you have any questions or concerns about our privacy practices, please contact us at:

Tranquil Minds Counseling
3606 Kimball Ave Ste 13  Waterloo, IA 50702
319-242-6140
nicolejohnson@tranquilminds-counseling.com